340B Drug Pricing Program Database
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DSH230059BH SAINT MARY'S HEALTH CARE (Terminated)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
MHPP Downtown OB Gyn - Northwest - OB Gyn
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059BH
Medicare Provider Number
230059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/21/2019
Last Recertification Date
9/5/2024
Termination Date
Termination Reason
4/1/2025
Site closure
Contacts
Authorizing Official
Trinity Health Muskegon Hospital
Daniel G. Green, Vice President for Finance
(616) 685-6709
Primary Contact
Saint Mary's Health Care
Robert D Bird, 340B Program Manager
(616) 685-1107
Addresses
Street Address
933 3 Mile Road NW
Suite 210
Grand Rapids, MI 49544
Billing Address
Mercy Health Saint Mary's
200 Jefferson Ave SE
Grand Rapids, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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